JAHA:肥胖与心衰恶化严重程度有关!

2018-03-15 xing.T MedSci原创

由此可见,基于大型人群的HF恶化患者数据,肥胖与急性严重程度指标较高有关,但住院死亡率较低。

肥胖和心力衰竭是重要的公共卫生问题。虽然研究已经报道了肥胖和慢性心衰发病率之间的关系,但肥胖与心衰恶化程度和住院死亡率的关系却知之甚少。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员的目的是调查肥胖与心衰恶化严重程度和住院死亡率之间的关系。

从2012年至2013年期间对7个州的心衰恶化住院成年人群进行基于人群的数据集(国家住院数据库)的回顾性队列研究。其结局为急性严重程度、使用正压通气、住院时间和住院死亡率。研究人员确定了肥胖与这些结果之间的联系,包括社会人口因素和合并症的调整。

研究人员确定了219465名因心衰恶化住院的患者。其中,肥胖者为37539例(17.1%)。肥胖患者有显著较高的正压机械通气的使用风险,与非肥胖患者相比(13.6% vs. 8.8%),并且相应的调整后比值比为1.61(95%可信区间为1.55-1.68;P<0.001)。同样,与非肥胖患者相比,肥胖患者更容易出现住院时间≥4天(62.5% vs. 56.7%),并且调整后的比值比为1.40(95%可信区间为1.37-1.44;P<0.001)。相反,肥胖患者住院死亡率显著低于非肥胖患者(1.7% vs. 3.3%),并且调整后的比值比为0.87(95%可信区间为0.80–0.95;P = 0.002)。

由此可见,基于大型人群的HF恶化患者数据,肥胖与急性严重程度指标较高有关,但住院死亡率较低。

原始出处:

Atsushi Hirayama,et al. Association of Obesity With Severity of Heart Failure Exacerbation: A Population‐Based Study.JAHA.2018. https://doi.org/10.1161/JAHA.117.008243

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  1. [GetPortalCommentsPageByObjectIdResponse(id=302074, encodeId=b29c3020e4bb, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c7052030458, createdName=1e2332e9m29(暂无匿称), createdTime=Mon Apr 02 17:20:21 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267770, encodeId=9718126e770a8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sat Mar 17 13:19:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296776, encodeId=20f8296e761a, content=那有没有考虑年龄的问题呢?①中年胖子与老年胖子的比例.②以及两者患病的比例③无疑.老年人的心衰恶化率高于中年.有所疑惑.请指教!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ced92278913, createdName=lencho, createdTime=Fri Mar 16 11:12:26 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296686, encodeId=527b2966867c, content=呵呵.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Fri Mar 16 07:07:15 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296614, encodeId=fb2a2966144c, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Mar 16 03:01:06 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=302074, encodeId=b29c3020e4bb, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c7052030458, createdName=1e2332e9m29(暂无匿称), createdTime=Mon Apr 02 17:20:21 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267770, encodeId=9718126e770a8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sat Mar 17 13:19:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296776, encodeId=20f8296e761a, content=那有没有考虑年龄的问题呢?①中年胖子与老年胖子的比例.②以及两者患病的比例③无疑.老年人的心衰恶化率高于中年.有所疑惑.请指教!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ced92278913, createdName=lencho, createdTime=Fri Mar 16 11:12:26 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296686, encodeId=527b2966867c, content=呵呵.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Fri Mar 16 07:07:15 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296614, encodeId=fb2a2966144c, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Mar 16 03:01:06 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
    2018-03-17 zhaohui6731
  3. [GetPortalCommentsPageByObjectIdResponse(id=302074, encodeId=b29c3020e4bb, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c7052030458, createdName=1e2332e9m29(暂无匿称), createdTime=Mon Apr 02 17:20:21 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267770, encodeId=9718126e770a8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sat Mar 17 13:19:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296776, encodeId=20f8296e761a, content=那有没有考虑年龄的问题呢?①中年胖子与老年胖子的比例.②以及两者患病的比例③无疑.老年人的心衰恶化率高于中年.有所疑惑.请指教!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ced92278913, createdName=lencho, createdTime=Fri Mar 16 11:12:26 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296686, encodeId=527b2966867c, content=呵呵.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Fri Mar 16 07:07:15 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296614, encodeId=fb2a2966144c, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Mar 16 03:01:06 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
    2018-03-16 lencho

    那有没有考虑年龄的问题呢?①中年胖子与老年胖子的比例.②以及两者患病的比例③无疑.老年人的心衰恶化率高于中年.有所疑惑.请指教!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=302074, encodeId=b29c3020e4bb, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c7052030458, createdName=1e2332e9m29(暂无匿称), createdTime=Mon Apr 02 17:20:21 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267770, encodeId=9718126e770a8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sat Mar 17 13:19:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296776, encodeId=20f8296e761a, content=那有没有考虑年龄的问题呢?①中年胖子与老年胖子的比例.②以及两者患病的比例③无疑.老年人的心衰恶化率高于中年.有所疑惑.请指教!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ced92278913, createdName=lencho, createdTime=Fri Mar 16 11:12:26 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296686, encodeId=527b2966867c, content=呵呵.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Fri Mar 16 07:07:15 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296614, encodeId=fb2a2966144c, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Mar 16 03:01:06 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
    2018-03-16 Drhzm308

    呵呵.学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=302074, encodeId=b29c3020e4bb, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c7052030458, createdName=1e2332e9m29(暂无匿称), createdTime=Mon Apr 02 17:20:21 CST 2018, time=2018-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267770, encodeId=9718126e770a8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Sat Mar 17 13:19:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296776, encodeId=20f8296e761a, content=那有没有考虑年龄的问题呢?①中年胖子与老年胖子的比例.②以及两者患病的比例③无疑.老年人的心衰恶化率高于中年.有所疑惑.请指教!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ced92278913, createdName=lencho, createdTime=Fri Mar 16 11:12:26 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296686, encodeId=527b2966867c, content=呵呵.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4c106013, createdName=Drhzm308, createdTime=Fri Mar 16 07:07:15 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296614, encodeId=fb2a2966144c, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Mar 16 03:01:06 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
    2018-03-16 飛歌

    厉害了我的哥

    0

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